Individual provider Active NPI

Waleed M El-Hitamy, OD

  • Optometrist
  • Lakeway, TX
National Provider Identifier
1407821903
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
05900T Issued in TX
Practice address
900 Ranch Road 620 S
B112
Lakeway, TX 78734-5615
Phone
(512) 263-0225
Fax
(512) 263-8590
NPI assigned
Feb 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 05900T TX Primary

Addresses

Primary practice location

900 Ranch Road 620 S
B112
Lakeway, TX 78734-5615

Mailing address

900 Ranch Road 620 S
B112
Lakeway, TX 78734-5615
Phone (512) 263-0225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041006001344 TX Practitioner - Optometry 4183683014 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05900TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeway Eye Center PC Optometrist CurrentSince Jan 19, 2001 Accepting new patients
Mozdbar Eyecare PLLC Optometrist PastSince Nov 17, 2024 Accepting new patients

Locations

900 Ranch Road 620 S
Ste B112
Lakeway, TX 78734
Phone (512) 263-0225

900 Ranch Road 620 S
Lakeway, TX 78734
Phone (512) 263-0225

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1407821903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RANCH ROAD 620 S",
            "address_2": "B112",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787345615",
            "telephone_number": "512-263-0225",
            "fax_number": "512-263-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 RANCH ROAD 620 S",
            "address_2": "B112",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787345615",
            "telephone_number": "512-263-0225",
            "fax_number": "512-263-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-HITAMY",
        "first_name": "WALEED",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "05900T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeway, TX

Sources for this page

Verify at the official NPI Registry.